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General NPI Number Information
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NPI Number | 1538773437
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Entity Type | Organization
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Legal Business Name | LESLEY HAWLEY MD LLC
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Dates
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Enumeration Date | 09/08/2020
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 3808 S GREYSTONE CT
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City | SPRINGFIELD
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State | MO
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Zip | 65804-6561
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Country | US
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Telephone | 417-889-3332
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Fax | 417-881-1410
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Provider Business Mailing Address
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Address Line | 3808 S GREYSTONE CT
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City | SPRINGFIELD
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State | MO
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Zip | 65804-6561
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Country | US
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Telephone | 417-889-3332
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Fax | 417-881-1410
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | LESLEY A HAWLEY
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Credential | MD
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Telephone | 619-315-9656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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